Elective recovery scheme ‘wide open to gaming’

Plans to pay trusts to validate and sometimes remove patients from their waiting lists could be “wide open to gaming” and create a public perception problem, senior NHS figures have told HSJ.

The new proposals were set out in the elective reform plan, published last week, which says NHS England “will ensure validation is, for the first time, formally reflected as a form of activity within the 2025-26 NHS Payment Scheme”.

HSJ understands the plans, already piloted by 10 trusts, involve relatively modest payments being paid to providers for “clock stops”—where an entry is removed from the referral to treatment waiting list—achieved by checking whether the entry remains valid.

So-called “removals other than treatment”, known as ROTTs, from the waiting list are common, and happen for numerous reasons such as patients moving house, no longer requiring the treatment, or having been treated elsewhere.

Waiting list expert Barry Mulholland, a partner at the MBI Health consultancy, said he was in favour of paying providers for ROTTs, but understood “concerns” among some in the NHS “that it provides an increased risk that patients may be removed incorrectly”.

Further details of the scheme are expected in the delayed 2025-26 NHS planning guidance.

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Source: HSJ, 15 January 2025